Facial perception of infants with cleft lip and palate with/without the NAM appliance.

OBJECTIVE: This study aimed to assess adults' subjective perception of infants with a unilateral cleft lip and palate (UCLP) with and without a nasoalveolar molding (NAM) appliance compared to those of controls concerning (1) adult gaze patterns and (2) emotional valence.

METHODS: This interdisciplinary study was performed by (1) the Department of Orthodontics and (2) the Department for Psychiatry and Psychotherapy, University Medical Center Goettingen, using eye tracking and a 10-point Likert scale questionnaire. Eye movements and valence rating of 30 unaffected adults (15 women, 15 men; mean age: 25.5 years, standard deviation [SD] = 7.5) were recorded while presenting them infants in three picture categories (1) infant with UCLP, (2) infant with UCLP and inserted NAM appliance and (3) infant without UCLP. Total fixation time in two main areas of interest (AOI upper/lower face) was measured according to picture category as well as participants' valence rating regarding infants' appearance.

RESULTS: In pictures of infants with UCLP or UCLP and NAM appliance participants had longer fixation times on AOI lower face compared to reconstructed pictures of infants without UCLP. No significant effect of a NAM appliance on gaze patterns could be detected. The valence of pictures of infants with UCLP was rated more negative compared to pictures of unaffected infants. An inserted NAM appliance improved this rating.

CONCLUSIONS: The results bolster the assumption that facial disruptions like UCLP alter adults' perception of infants. Even though the NAM appliance is not able to re-establish usual adult gaze patterns, it can help to improve adults' emotional assessment.